A. L. Hillman

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OBJECTIVES A randomized controlled trial evaluated the impact of feedback and financial incentives on physician compliance with cancer screening guidelines for women 50 years of age and older in a Medicaid health maintenance organization (HMO). METHODS Half of 52 primary care sites received the intervention, which included written feedback and a financial(More)
OBJECTIVE Immunizations and other cost-effective preventive services remain underused by many children, especially those living in poverty. Given the effectiveness of provider-based tracking systems and the widespread use by managed care organizations of financial incentives to influence physician practice patterns, we designed and tested an intervention(More)
This paper studies the prospects of implementation of guest-worker programs by governments that are based on an intended temporary presence of foreign workers. The purpose of guest- worker programs is to alleviate sector-specified labor shortages. The intention of a temporary stay is reflected in families left behind, and in the employers that often(More)
It has been suggested that the use of financial incentives by health maintenance organizations (HMOs) may change physicians' behavior toward individual patients. To test this hypothesis, we used a regression analysis of data from a survey of HMOs to examine the relation between the presence of financial incentives and two measures of the use of resources(More)
Do financial incentives used by health maintenance organizations (HMOs) to restrain the use of health care resources represent a conflict of interest between physicians' concern about their income and their concern about patients? To explore the contractual obligations of primary care physicians in HMOs, I mailed a survey to all 595 HMOs known to be in(More)
With the growing international literature in economic evaluation and the rapid spread of new health technologies, there is a need to undertake, or at least interpret, economic evaluations on the international level. However, the ways in which cross-national differences affect the cost-effectiveness of health technologies or their evaluations have never been(More)
OBJECTIVE This study examines hospital motivations to acquire new medical technology, an issue of considerable policy relevance: in this case, whether, when, and why hospitals acquire a new capital-intensive medical technology, magnetic resonance imaging equipment (MRI). STUDY DESIGN We review three common explanations for medical technology adoption:(More)
In this paper, cost and effectiveness data for six clinical interventions are applied simultaneously to a hypothetical population of 100,000 patients to show how selecting guidelines to maximize overall population benefit compares with selecting the best guidelines for individual patients. By entering effectiveness (added survival) and cost information from(More)
OBJECTIVES We developed a decision analytic model to compare the costs of treatment for an initial 2-year period with finasteride, terazosin, and transurethral resection of the prostate (TURP) in men with at least moderate symptoms of benign prostatic hyperplasia (BPH). Outcome measures were BPH treatment costs, duration of symptomatic improvement, and lost(More)
OBJECTIVE To determine clinical and economic consequences of alternative vaccination strategies for preventing hepatitis B virus infection (HBV). METHODS Decision analysis was used to evaluate costs, outcomes, and cost-effectiveness of three HBV management strategies ("no vaccination," "universal vaccination," and "screen and vaccinate") in four(More)